my flight of ideas

This morning I was posted at the PGH Outpatient Department’s Section of Dermatology.

From a medical intern’s standpoint, interviewing and examining patients with skin diseases is like a highly intellectual game of show-and-tell: the patient shows you what’s on his/her skin, you tell the resident what the patient has.

It would not be worth blogging a daily encounter if there was nothing special, of course:

One of my patients was a 27 year old female who, to fast track, was diagnosed with something akin to skin darkening after using too much skin whitening products and then exposing yourself to the sun.

She came in, very particular about these black macules (spots) on her face.

Yes, she was thorough in telling me everything – down to the last detail about her concerns on bad breath.

Being the compassionate student physicians that we are (or are supposed to be?), I listened.

After taking down her disease’s history, I invited her over into the examination cubicle for better positioning and lighting. Inside was a recliner chair similar to that used by dentists, draped with green hospital linen and lighted well, as it should be.

On seeing the set-up, my patient’s eyes light up. She looks at me with great expectation, and asks…

It was an “oops, ay…” moment. Oops, because she saw the shock in my face; Ay…, because I tried to be most tactful in telling her that a massage is not part of my job description.

But wait, there’s more!

In the course of presenting her case to my resident, the patient is told to use sunblock lotion every morning as part of her prescribed regimen. Training institution setting as it is, the detailed advice is expected to be delivered by me, while the resident moves on to check other patients.

I told Ms. Massage-me-Doc that she should apply sunblock lotion of any brand, so long as it is at least SPF Factor 30. The lotion was to be applied in the morning at least 30 minutes before going out into the sun.

I was expecting the usual follow-up question “Doc, ano yung SPF?” (Doc, what is SPF?) When, perky as ever, she asks me:

“Ah, thirty minutes ilalagay ang sunblock bago maarawan sa umaga.” (Oh, sunblock should be applied thirty minutes before sun exposure in the morning.) She understood. Then… “Eh paano siya gamitin sa gabi?” (Umm, how do you use it at night?)